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Because of the complex innervation and re-innervation features of the larynx [1], paralysis of the vocal folds (VFs) is not atypical paralytic condition as seen in extremities. Bilateral laryngeal nerve injury may be a life-threatening clinical entity which may need management under emergency conditions. It is important to make a distinction between cricoarytenoid joint fixation and loss of innervation in order to proceed for treatment bilateral vocal fold immobility (BVFI). Laryngeal electromyography and palpation of the arytenoid may help this distinction. Surgical trauma (i.e. thyroidectomy) is the most common cause of BVFI [2].

international journal of clinical and experimental otolaryngology

A Combined Endolaryngeal Approach for Bilateral Vocal Fold Immobility: Microlaryngoscopic Submucosal Cordotomy and Endo-Extralaryngeal Triple-Suture Lateralization